Hi. I posted before and some of you were kind enuogh to respond. My now one year old is still struggling with acid reflux. He is taking prevacid but still will not swallow solid foods. He has been on formula since 9 months, first soy formula, but when he started throwing everything up for 3 days strait they switched him to Alementum (plus zantac) that seemed to work at first but he became very congested and after about 2 weeks started throwing that up, except this time his vomit was thick and mucusy. So we switched him back to soy. He has been on the soy for about 4-6 weeks but this last week he threw everything up 3 nights. Its alway at bedtime- never during the day. I don't know what to do for him. He seems not to be able to get anything in without it coming back up at night. Why at bed time? Also, he wakes 2ce a night to eat still (at 2 and at 5) and those feedings are uneventful. I am feeling a little lost.
Q: My 1 year old has been on antacid for the last 3 months but is still throwing up and gaging at night
Hello Sam,
I am sure you are frustrated that the reflux is going on and on with your little guy. It is not common for the vomiting to continue so long. I wonder if you have been referred to a gastroenterologist yet. It might make sense to get the opinion of the specialist since you have tried medication and dietary changes already.
Reflux symptoms may be worse at night when you are reclined and the esophagus is more horizontal, leading to more regurgitation. It is difficult to elevate a one year old safely. Reducing or eliminating the night feedings may be important unless the doctor thinks your son needs the extra calories at night. I fed my daughter with reflux at night for a long time. It was a long and very slow process to gradually decrease the amount of each night feeding and then switch to water only (oh she really disliked that idea!). Sleeping on a empty stomach may be really important and a good long term goal as part of the treatment plan.
Now that he is a year old, the doctor may want to adjust his diet somewhat. Since he is having trouble swallowing, he may need more of a liquid diet right now. The doctor and GI doctor can help you decide if the swallowing issues are due to the reflux or a swallowing/sensory issue. It may be necessary to have a consultation with a feeding therapist. Let me know if you need information on that topic.
Take care,
Jan
Hello!
So glad you are working with a gastroenterologist. You and your son certainly need a sleep solution!
I wonder if he has had a swallow study to assess his swallow? Perhaps you could ask the feeding therapist and the doctor if thickening the formula would help. Certainly if he is able to tolerate a smaller amount in the bottle, that might be a start toward weaning him from the evening bottle. Maybe decrease the amount gradually by an ounce per week. If the doctor thinks he is getting enough calories by day, it is unlikely that hunger is waking him up.
Is he having difficulty using a cup? Cup drinking is more upright and so gravity might help keep the liquid from refluxing.
Sometimes the doctor will recommend a sleep study or a pH probe to try to determine the cause of the sleep issues. Other causes of night waking include large adenoids, sleep apnea, fluid in the ears, etc, etc.
I was on the night shift for a long time too. My brain did not work very well. I managed to take a nap on most days. I wonder if you can bank some sleep during the weekends when dad or another family member might be able to give you a break. I used to sleep when my refluxer would sleep and the other kids, ages 3 and 5 watched a educational video or played quietly. They knew that mom was not to be disturbed unless the house was burning down. It really did help so much. Other nights, I just went to bed as soon as the kids were in bed. Even if it was 8pm.
Hang in there and I hope you are both sleeping through the night very, very soon.
Jan Gambino
The Reflux Mom
www.refluxmom.com
Antacids are not the resolution for throwing up, they are to neutralise the stomach acid (Hydrochloric Acid, HCl).
There may be many reasons for the actual throwing up and gaging. There could be increased contracture of the diaphragm secondary to irritation of the Phrenic Nerve, the nerve that innervates the diaphragm, which exits from the vertebral column in the neck. Any complications during the birth process or the use of a ventouse or forceps may well have caused unidentified problems here. Hence, was the birth traumatic/complicated? Was a ventouse/forceps used?
Alternatively, the Vagus nerve, the nerve that innervates the stomach and oesophagus as well as many other structures, could be irritated at its exit point just at the base of the skull. This could cause malfunction of these structures and therefore the sympotoms. Once again, i would need to know the birth procedure in order to depict a better picture.
Also, the baby's sleeping position may well impact on the neck. Does he have a side which he prefers to rest his head on? The curves in his back could be irritating the outflow of local nerves.
In summary, i would suggest you consulted your baby to an Osteopath, in particular one with a special interest in Paediatric Cranial (or Cranio-Sacral) Osteopathy.
Hope this helps.
I feel for you so! We struggled with what sounds so similar with our daughter when she was 2-3 months old. It started when she ended up in the ER for 3 days at 2 weeks old (due to a fever). She was given IV antibiotics for 48 hours. After this episode, she started with horrible reflux. They may have not been related.
We went through all formulas there are. First had blood in stool from soy, then supposedly allergic to milk, no more breastfeeding, alimentum, nutramigen... Finally, she was really diagnosed with GERD, reflux, and cetiph (apparently from the antibiotics).
SO... she is now 1. Prevacid never worked, Zantac worked. EleCare REALLY worked. At 3 months old, this all finally worked. She is still on EleCare, still can't have cow's milk and has several allergies to foods.
My first peice of advice, has anyone really diagnosed him properly? Although horrible for her to have upper GI, ultrasound, etc.; we finally figured out what was really wrong(more than anything, we ruled out the serious stuff).
NEXT, see what elecare does. It was a miracle for us.
Nightime, Why At Night? Lying down is horrble for them, with GERD and anything similar, the acid build up comes up when horizontal (in addition to the esophagus issues). My daughter started sleeping on her stomach very young on her own (b/c thats the only way she could sleep). Also, we loaded the EleCare with cereal (starting gradually and increasing over time). A doctor can advise you regarding your elecare to water ratio AND the elecare to cereal ratio.
CEREAL - BEECHNUT Mixed Cereal or Whole Grain Cereal (without soy) seems to be the most hypoallergenic (have heard from several doctors and other mothers). My daughter could not handle Gerber, etc. or any cereal with Iron, DHA/RHA. Why? the iron is self explanatory, maybe the DHA/RHA just a coincidence.
WATER - Also may be coincidence, but Nursery Water (sold in gallons at most stores) also made a difference. I started using this for the fluoride for her teeth (some cities do not have as much Fl in their H20 and most bottled water has no Fl).
And lastly, I cut the evening feedings. As long as you are confident that they have eaten or drinken their "ounces" during the day, you can feel confident putting them down at night. They are like us, meant to be able to go 12 hrs w/o eating. AND as incredibly difficult as this is, do it for him, he must learn this for his metabolism... if it's ever going to be right, he should go 12 hrs w/o eating when he is an infant.
Don't worry about others telling you "no more bottles" or "he must eat food". You do what's right for your child. As long as he is growing!
I feel for you! My advice is purely mine and may not work for anyone else, but I can be a supportive "mom" for you as I am pretty sure I think I know how you feel.
Just one more note to the above. We are off of Zantac now, still using EleCare with Cereal (but down to 3 bottles/day). Eating solids okay (BUT we have the allergy thing to deal with so just eating anything doesn't work). I did the whole 3 tablespoons of a new solid/day for 3 days, then added and added. Great method as we found she was allergic to quite a few foods you would never think of (i.e. bananas, squash, maybe eggs). The potential egg allergy is very serious as some vaccines are made with eggs (i.e. flu shot). They normally grow out of these allergies.
At this point, I am wondering what I am going to give her next as she can't have cow's milk at this time. Also, we are dealing with constipation now. SO... it can get better and as long as he's growing, you just do what you need to do. Sit him up with you in bed if you have to. At 1 he is old enough to sleep in many positions as long as he is strong enough to roll over, etc.
I am so sorry, I will say a special prayer for you tonight that this turns around, hang in there!!!
Laura, Thank you for sharing your experiences. I agree with you that it is difficult to eliminate the night feeding but it may prove to be very beneficial. Good luck to you as your journey continues.
Also, I am quite sure Elecare has a "toddler formula" for transitioning from infant formula after 12 months. Many toddlers with reflux are not ready to go from special formula to cow's milk so there are several brands and formulations available. The doctor can guide you on this. You may need to order from the pharmacist since this type of formula may not be on the shelf.
Best wishes,
Jan
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Thanks Jan.
Actually I have seen a gastroenterologist (sp?) He is the one who perscribed the prevacid, and I am taking my son to "swallow therapy" once a week with a specialist. We just switch his formula (again) to Elecare, which is completely amino acid based seeing he seems to have dificulty on the alimentum and the soy formula, the GE thinks he may have dairy and soy allergies. If he continues to throw up on the Elecare I don't know what else to do. I will say that his height/weight is fine. He is able to take the bottle during the day with out much ado, its that bedtime bottle that always comes back up. I'm thinking of trying to eliminate that last feeding somehow. I feel like if I can get him on solids this will resolve, but until then- its rough going for everyone. 374 days (and counting) without a full nights sleep is making me loopy.... Thanks again for your support.
Sam